part ii: periodontal debridement. routine prevention or necessary treatment? dental prophylaxis or...
TRANSCRIPT
Part II:Periodontal Debridement
Routine Prevention or Necessary Treatment?
Dental prophylaxis OR periodontal therapy Removal of deposits from supragingival and
subgingival surfaces of the teethUses nonsurgical instrumentationTo prevent OR arrest infection General anesthesia
What does that entail? Risks Cost
Explore the Teeth
Dental explorer – has a slender, wire-like working end that tapers to a sharp point and is used to explore the topography of the tooth surface (crowns)
Explore caries Acid producingbacteria demineralization of enamel and dentin What is the most common surface affected?
Looking for pulp exposure
Check for Attachment Loss
Periodontal probe Round, blunt instrument Miniature intraoral ruler measures:1. Attachment levels (gingival recession and sulcus depths)
2. Loss of bone in furcation areas
Used to assess mobility of teeth and the presence of gingival bleeding.
What is normal sulcus depth for a canine? Feline?
Periodontal Probe
Williams’ markings have millimeter increments at 1,2,3,5,7,8,9 and 10mm.
Calculus Removers
Removes gross calculus, supragingivally
Which teeth do you think need this tool the most?
Scaling Above the Gingiva
Hand scaler – used to remove tartar / calculus supragingivally
Modified pen grasp technique Gives precise control of the instrument; limits wrist
motion Where should all of your fingers be?
Working end
Shank
Handle
Scaling Below the Gingiva
Curette-used to remove tartar subgingivallyModified Pen Grasp*Tip is more round/dull than the hand scaler.
Periodontal Debridement Using Machines
Ultrasonic scaler- uses vibrations and irrigation to remove tartar from surface of tooth. Steady stream of water (strong mist) flushes out the
sulcus AND can disrupt bacterial cell walls
Ultrasonic Scaler
Water through the tip also acts as a coolant; this machine can get very hot!
Move tip from the sulcus, down the Crown, to the apex.Time line/tooth?
Ultrasonic Scalers: Two Options
1. Magnetostrictive- magnetic field in the hand piece is created by zinc and nickel, sends vibrations to the tip in an elliptical pattern
All surfaces of the tip vibrate! Most vibrations are on the tip
Use least amount of vibrations Found on the lateral surfaces
Magnetostrictive Scaler
INCORRECT Distal third of tip should be
held at 0-15° from long axis of the tooth.
Ultrasonic Scalers: Two Options
2. Piezoelectric- ceramic discs or crystal that produces linear movements
Only lateral surfaces vibrate More skill required
More fragile/breakable Expensive
Periodontal Debridement
Polishing – VERY IMPORTANT The scaler microscopically scratches the tooth surface
and creates more surface area quicker bacterial build up
1-3 seconds/toothProphy angle- attachment that is connected
to the hand piece Removable rubber cup holds polish, or prophy paste
Patient Position/Safety
Comfortable for you and the patientPlenty of lightElevate neck; nose downOpening of mouth
Oral speculumSuction/gauzePreemptive rinsePPE
Feline Mouth Gags
Cornell StudyMaxillary artery
blockedBlindness
Periodontal Debridement Safety-PPE
Dental Radiographs
Manual Processing: uses film and developing solutions
Computed RadiographyDigital Radiography
Manual Processing
Dental Radiology Techniques
Parallel TechniqueBisecting Angle Technique